National Provider Identifier [NPI]: |
1902841588 |
Last Name Of The Provider |
KROOK |
First Name Of The Provider |
JON |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 PARK AVE |
Street Address 2 Of The Provider |
PURPLE 5 |
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554151623 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
468 |
Number Of Medicare Beneficiaries |
174 |
Total Submitted Charge Amount |
142494.25 |
Total Medicare Allowed Amount |
62616.3 |
Total Medicare Payment Amount |
47949.15 |
Total Medicare Standardized Payment Amount |
51050.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
468 |
Number Of Medicare Beneficiaries With Medical Services |
174 |
Total Medical Submitted Charge Amount |
142494.25 |
Total Medical Medicare Allowed Amount |
62616.3 |
Total Medical Medicare Payment Amount |
47949.15 |
Total Medical Medicare Standardized Payment Amount |
51050.23 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
105 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
82 |
Number Of Non Hispanic White Beneficiaries |
94 |
Number Of Black or African American Beneficiaries |
69 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
51 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
123 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.3321 |